Pregnancy After Loss–The Dread of The Occasional Encounter

There are people in our lives we only see intermittently. We see the dentist once or twice per year. We see our hairstylist every two to three months (or longer if you are growing it out.) We see certain out of town colleagues only at the big meeting in April. And we see our third cousin twice removed at the family reunion once every summer. How should these occasional encounters be dealt with when you lose a baby and then are pregnant again?

There’s no right or wrong answer. Much of what you decide to do will depend on your unique circumstances: What happened? Who knows about it? What is your relationship with this person? What do you want this person to know or not know?

Sometimes, loss parents aren’t sure what exactly they want to happen in a particular interaction after the loss. However, they do know that they wish to avoid awkwardness, pity, or having to discuss details of the loss. Many of my clients express worry and dread in anticipation of these occasional encounters.

Some of this is hard to avoid when there is a new pregnancy. When you are pregnant again after a loss, others will inevitably want to congratulate you. People you don’t see very often may not have heard about the new pregnancy (or the loss). Occasionally, someone has heard about the first pregnancy but not the loss of that pregnancy nor about the subsequent pregnancy. Someone at a wedding once wished me “Congratulations!” and I knew right then and there that the Little Black Dress I carefully chose camouflaged my belly about as well as an elephant hiding behind a floor lamp. It was not the pregnancy she thought it was. I was caught in a dilemma. Do I clarify the situation and make it awkward (and possibly cry)? Or, do I thank her for her good wishes and change the topic? In most situations like this, I found myself disclosing what had happened but did it so quickly that the person could barely process what I was saying. In a matter of seconds, I was reassuring them, “But it’s okay! We are doing better and look, I am pregnant again!” (It was untrue that the new pregnancy made it “all better.”) I don’t do this anymore because it’s not my responsibility to make others feel better about my pregnancy loss.

There are a few strategies my clients have used to deal with these types of encounters. Here are some popular ones:

1. Get the word out in advance.

Sending the news ahead of time about the new pregnancy can help make things go more smoothly whether it’s a family wedding or a regional office meeting. Specify whether you want others to acknowledge the situation. The message might not reach everyone but if you trust someone to brief the key people then you might avoid some painful interactions. Some people prefer that others not acknowledge a new pregnancy. Others are fine with an acknowledgement but don’t want to get into details or deal with over-the-top displays of excitement by others that don’t match up with the fear and trepidation they are feeling.

2. Provide just the necessary information.

With service providers like doctors, dentists and hairstylists, share as much or as little as you deem appropriate and comfortable. In a medical setting, it may be relevant to disclose, especially if it’s time to get x-rays at the dentist. Being prepared for an enthusiastic “Congratulations!” may help a little bit. If you want to avoid further talk about it, you can say, “I am not really up for talking about it, but thank you for your good wishes.” Or, “I am not wanting to get into details, but I need you to know for medical purposes that I am 8 weeks pregnant.”

3. Keep it all business.

In work settings, you don’t have to participate in conversations related to pregnancy if you are uncomfortable. Be polite but firm. If you need to leave, just excuse yourself and come back later when the conversation has ended. If leaving isn’t possible, change the topic.

4. Finally, realize that you can’t control every conversation or interaction.

There may be times when things don’t go the way you had planned. Someone will always say something insensitive. Most of the time, people want to be compassionate and helpful but don’t know how to best do that. I also encourage people to realize that having had a pregnancy loss makes others uncomfortable in that they don’t know what to say or do. So news of a new pregnancy is not just exciting but relieving—for the other person! They are happy for you but also comforted that the awkwardness of acknowledging your loss (or not acknowledging it) has passed. Those of us who have had losses know that the loss is still with us even in a new pregnancy.

Overall, being self-compassionate can go a long way. If an interaction doesn’t go well, take some time to yourself later to do something fun or relaxing. You are doing the best you can under difficult circumstances. A new pregnancy can be a happy event but is often complicated when there’s been a loss. Know that there are many women who have walked this path before you. You are not alone.

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Rachel E.K. Freedman, Ph.D. is a licensed psychologist in Bethesda, Maryland who specializes in perinatal loss. After experiencing her own termination for medical reasons (TFMR) and finding very few in-person resources, she started an in-person TFMR support group that has run for the past 8 years. Rachel went on to have two healthy pregnancies and now is the proud parent of two girls. She also writes and speaks on topics pertaining to perinatal loss, trauma, and women’s issues. She can be reached at rachelfreedmanphd@gmail.com.